Rare high branching pattern from the first part of the right axillary artery

A 77-year-old female cadaver was observed to have a rare branching pattern of the right axillary artery (AA)  The first part of the AA typically gives off only a superior thoracic artery (STA) but was observed to give off three branches in the case: a lateral thoracic artery (LTA), a thoracoacromial trunk (TAT), and a large common trunk (CT). The LTA traveled to provide a variant STA to the 1st and 2nd intercostal spaces. The CT provided an accessory lateral thoracic artery (aLTA) and accessory thoracodorsal artery (aTDA) before bifurcating into a subscapular artery (SA) and posterior humeral circumflex artery (PHCA). As expected, the SA further divided into the circumflex scapular artery (CSA) and thoracodorsal artery (TDA). A pectoral artery and the anterior humeral circumflex artery (AHCA) originated directly from the second and third parts of the AA, respectively. Knowledge of AA branching variations is of great clinical significance to anatomists, radiologists, and surgeons due to the high rate of injury to this artery

Lessons learned from COVID-19 Lockdown: An ASPED/MENA Study on Lifestyle Changes and Quality of Life during Ramadan Fasting in Children and Adolescents living with Type 1 Diabetes

Background: Lockdown was a unique experience that affected many aspects of life, particularly during the challenge of Ramadan fasting (RF). Studying this can increase understanding of the effects of lifestyle changes on quality of life (QoL) for children with type 1 diabetes (T1D) during RF. Methods: A cross-sectional study that assessed the effect of lockdown on lifestyle and QoL on fasting children living with T1D during Ramadan in the Middle East and North Africa region (2020-2021). We compared the child (self) and parent (proxy) reports using PEDQoL v3.0 disease specific questionnaire during lockdown and non-lockdown periods, and assessed correlations with lifestyle changes using regression and gap analyses. Results: A total of 998 reports from 499 children with T1D aged 8-18 years (study=276, control=223), and their parents during RF in lockdown and non-lockdown periods. Fathers were more involved in their children’s care during lockdown (p=0.019). Patients had better compliance with treatment (p= 0.002), a reversed sleep pattern (p= 0.033), increased food intake (p=<0.001) and less exercise (p<0.001). Children and parents perceived better QoL during lockdown (p=<0.001) with no differences between their reports in “Diabetes Symptoms”, “Treatment Adherence” and “Communication” domains. Self and proxy reports were different in all domains during non-lockdown (p-values <0.001- 0.009). In gap analysis, although not statistically significant, the gap was approximated between children’s and parents’ perceptions in all domains during lockdown. Conclusion: COVID-19 lockdown had a positive impact on QoL of children living with T1D during RF, possibly due to lifestyle changes and superior psychosocial family dynamics

Temperatures of Exploding Nuclei

Breakup temperatures in central collisions of 197Au + 197Au at bombarding energies E/A = 50 to 200 MeV were determined with two methods. Isotope temperatures, deduced from double ratios of hydrogen, helium, and lithium isotopic yields, increase monotonically with bombarding energy from 5 MeV to 12 MeV, in qualitative agreement with a scenario of chemical freeze-out after adiabatic expansion. Excited-state temperatures, derived from yield ratios of states in 4He, 5Li, 6Li, and 8Be, are about 5 MeV, independent of the projectile energy, and seem to reflect the internal temperature of fragments at their final separation from the system. PACS numbers: 25.70.Mn, 25.70.Pq, 25.75.-qComment: 10 pages, RevTeX with 4 included figures; Also available from http://www-kp3.gsi.de/www/kp3/aladin_publications.htm

Ins and Outs of Cerebellar Modules

The modular concept of cerebellar connections has been advocated in the lifetime work of Jan Voogd. In this concept, a cerebellar module is defined as the conglomerate of one or multiple and non-adjacent, parasagittally arranged zones of Purkinje cells, their specific projection to a well-defined region of the cerebellar nuclei, and the climbing fiber input to these zones by a well-defined region of the inferior olivary complex. The modular organization of these olivo-cortico-nuclear connections is further exemplified by matching reciprocal connections between inferior olive and cerebellar nuclei. Because the different regions of the cerebellar nuclei show highly specific output patterns, cerebellar modules have been suggested to constitute functional entities. This idea is strengthened by the observation that anatomically defined modules adhere to the distribution of chemical markers in the cerebellar cortex suggesting that modules not only differ in their input and output relations but also may differ in operational capabilities. Here, I will briefly review some recent data on the establishment of cerebellar modules in rats. Furthermore, some evidence will be shown suggesting that the other main afferent system (i.e., mossy fibers), at least to some extent, also adheres to the modular organization. Finally, using retrograde transneuronal tracing with rabies virus, some evidence will be provided that several cerebellar modules may be involved in the control of individual muscles

Multi-band analyses of the bright GRB~230812B and the associated SN2023pel

GRB~230812B is a bright and relatively nearby ($z =0.36$) long gamma-ray burst that has generated significant interest in the community and therefore has been subsequently observed over the entire electromagnetic spectrum. We report over 80 observations in X-ray, ultraviolet, optical, infrared, and sub-millimeter bands from the GRANDMA (Global Rapid Advanced Network for Multi-messenger Addicts) network of observatories and from observational partners. Adding complementary data from the literature, we then derive essential physical parameters associated with the ejecta and external properties (i.e. the geometry and environment) and compare with other analyses of this event (e.g. Srinivasaragavan et al. 2023). We spectroscopically confirm the presence of an associated supernova, SN2023pel, and we derive a photospheric expansion velocity of v $\sim$ 17$\times10^3$ km $s^{-1}$. We analyze the photometric data first using empirical fits of the flux and then with full Bayesian Inference. We again strongly establish the presence of a supernova in the data, with an absolute peak r-band magnitude $M_r = - 19.41 \pm 0.10$. We find a flux-stretching factor or relative brightness $k_{\rm SN}=1.04 \pm 0.09$ and a time-stretching factor $s_{\rm SN}=0.68 \pm 0.05$, both compared to SN1998bw. Therefore, GRB 230812B appears to have a clear long GRB-supernova association, as expected in the standard collapsar model. However, as sometimes found in the afterglow modelling of such long GRBs, our best fit model favours a very low density environment ($\log_{10}({n_{\rm ISM}/{\rm cm}^{-3}}) = -2.16^{+1.21}_{-1.30}$). We also find small values for the jet's core angle $\theta_{\rm core}={1.70^{+1.00}_{-0.71}} \ \rm{deg}$ and viewing angle. GRB 230812B/SN2023pel is one of the best characterized afterglows with a distinctive supernova bump

CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p&lt;00001), age 70 years or older versus younger than 70 years (230 [165-322], p&lt;00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p&lt;00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research